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Journal of Clinical Endocrinology & Metabolism Vol. 72, No. 3 724-726
doi:10.1210/jcem-72-3-724
Copyright © 1991 by the Endocrine Society.
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Pneumocystis Carinii Infection of the Thyroid in a Hypothyroid Patient with AIDS: Diagnosis by Fine Needle Aspiration Biopsy*

RUGGERO BATTAN*, PETER MARIUZ{dagger}, MARIO C. RAVIGLIONE{ddagger}, MARIA T. SABATINI, MICHAEL P. MULLEN and LEONID PORETSKY

Departments of Medicine and Pathology (M.T.S.), Cabrini Medical Center New York, New York 10003
New York Medical College Valhalla, New York 10595

Address all correspondence and requests for reprints to: Dr. Leonid Poretsky, Division of Endocrinology, Cabrini Medical Center, 227 East 19th Street, New York, New York 10003.

A 49-yr-old homosexual man with acquired immunodeficiency syndrome presented with a left-sided neck mass. He was found to have a firm goiter. He was clinically euthyroid, but had laboratory evidence of primary hypothyroidism. Radioactive iodine scan of the thyroid showed homogeneous uptake over an enlarged right lobe and absence of uptake over the left lobe. Two fine needle aspiration biopsies of the thyroid revealed the presence of Pneumocystis carinii (P. carinii) organisms on the Gomori’s methenamine silver stain. After courses of iv and oral therapy with trimethoprim-sulfamethoxazole, a third fine needle aspiration biopsy failed to reveal any organisms. A repeated radioactive iodine scan of the thyroid showed return of uptake over the left lobe. Thyroid function tests normalized with levothyroxine, and the goiter decreased in size. To our knowledge, this is the first report of hypothyroidism associated with P. carinii infection of the thyroid. P. carinii infection should be considered in the differential diagnosis of human immunodeficiency virus infected individuals presenting with cold thyroid nodules. Fine needle aspiration biopsy is a valuable tool in assessing these patients.

* This work was supported by NIH Grant HD-22738 and the Roberto Pope Research Fund at Cabrini Medical Center.

{dagger} Current address: Division of Endocrinology and Diabetes, University of Massachusetts Medical Center, Worcester, Massachusetts 01655.

{ddagger} Current address: Division of Infectious Diseases, State University of New York, Stony Brook, New York 11794.

§ Current address: Division of Infectious Diseases, Beth Israel Hospital, Boston, Massachusetts 02215.

Received July 19, 1990.




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Home page
Arch Intern MedHome page
R. Guttler and P. A. Singer
Pneumocystis carinii Thyroiditis: Report of Three Cases and Review of the Literature
Arch Intern Med, February 8, 1993; 153(3): 393 - 396.
[Abstract] [PDF]




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